1. Field of the Invention
This invention is directed to the application of tractive force to the skeletal frame of the patient.
Tractive force is applied in various manners. Often, externally applied skin traction may be used to maintain the desired skeletal tractive force for the necessary amount of time. While this technique causes a minimum of discomfort and minimizes risks of infection, the amount of force applied by this method, particularly over any considerable time period, is limited.
In some instances, tractive force may be applied by applying leverage with an undamaged extremity member, particularly when the undamaged extremity member is located further from the torso than the damaged member and the undamaged extremity may comfortably be held at a more or less fixed angle such as 90.degree..
In other cases, particularly in cases of compound fractures, it may be necessary to surgically expose bone tissue and directly apply a splint to the damaged bone. By bridging the fracture with the splint, the bone segments are maintained at the desired separation distance from one another. While this procedure may be necessary in some instances, there are other instances where bone healing would likely take place without the application of such a splint if tractive force could be applied to the bone.
In cases where traction is to be directly applied to the skeletal structure but it is not otherwise necessary to directly apply a splint to the damaged bone, a technique using a pin and bow has been used. The pin is inserted into the patient's extremity so as to pass through a portion of the bone to which tractive force is to be applied. The pin is inserted so that both ends extend beyond the skin of the patient and these ends are gripped by a bow member. The bow member, in turn, has a cord attached thereto and tractive force is applied by the cord, usually by passing the cord through a pulley and suspending an appropriate amount of weight at the opposite end of the cord which hangs down from the pulley. The pin and bow technique permits the application of traction directly to a patient's bone while minimizing the amount of surgical procedure required for the application of such traction. In many cases, this technique also simplifies the application of traction over externally applied traction techniques in that the patient is given more flexibility within his confined situation.
The nature of bone fractures are such that there are many cases in which traction is advantageously applied in a medical emergency operating room, or even in a remote location such as an ambulance. In such situations, it is desirable that the amount of preparation required for surgery be minimized. This preparation not only includes the appropriate sterilization of the items, but also the collection of all of the equipment needed for this type of surgery. It is desirable that all of the equipment needed for the surgical procedure be readily available in a unitary package, not only because of the time factors involved in the emergency situation, but also because a set of equipment requiring a minimum of storage space can be more readily stored for rapid access to the equipment, particularly in locations where space is limited.
The use of the pin requires that some means be provided for the insertion of the pin in the body. This is normally accomplished by a drill such as a brace and bit. Usually the pin is formed with appropriate cuts or grooves so as to facilitate boring into the patient's body and particularly into the patient's bone. The pin is therefore functional as the bit in the brace and bit. The brace and bit has the advantage that rotational movement of the bit is relatively slow, thereby reducing necrosis of the tissue surrounding the puncture site.